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Lookup NU author(s): Professor Matthew Collin
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© 2020, The Author(s), under exclusive licence to Springer Nature Limited. The optimal conditioning for patients with acute myeloid leukemia in first complete remission treated with allogeneic hematopoietic cell transplantation (allo-HCT) has not been defined so far. In this retrospective study, we compared two “reduced-toxicity” regimens: intravenous busulfan at a total dose of 9.6 mg/kg (3 days) + fludarabine (Bu3/Flu) and total body irradiation at a dose of 8 Gy + fludarabine (TBI8Gy/Flu). In the entire study cohort (n = 518), the probabilities of overall survival (OS), leukemia-free survival (LFS), relapse and non-relapse mortality (NRM) at 2 years for Bu3/Flu and TBI8Gy/Flu were 62% vs. 72.5% (p = 0.051), 59.5% vs. 65% (p = 0.15), 30% vs. 20% (p = 0.01), and 10% vs. 14% (p = 0.18), respectively. In multivariate model for patients <50 years old, TBI8Gy/Flu was associated with improved LFS (hazard ratio (HR) = 0.5, p = 0.04), OS (HR = 0.31, p = 0.004), and survival free from both graft-versus-host disease and relapse (HR = 0.55, p = 0.03), as well as tendency to reduced risk of relapse (HR = 0.53, p = 0.08). Among patients aged 50 years or older the use of TBI8Gy/Flu was associated with increased incidence of NRM (HR = 3.9, p = 0.0009), with no significant impact on other outcome measures. We conclude that the use of TBI8Gy/Flu as “reduced-toxicity” regimen may be advised in younger patients with AML referred for allo-HCT.
Author(s): Giebel S, Labopin M, Sobczyk-Kruszelnicka M, Stelljes M, Byrne JL, Fegueux N, Beelen DW, Rovira M, Spyridonidis A, Blaise D, Bornhauser M, Karadogan I, Savani BN, Nagler A, Mohty M, Martin S, Chevallier P, Neubauer A, Damaj G, Koc Y, Ganser A, Collin M, Yakoub-Agha I, Ozdogu H, Araujo MC, Itala-Remes M, Orchard K, Isaksson C, Bethge W, Martin H, Aljurf M, Faber E, Caballero D, Zak P, Leleu X, Bay J-O, Rohrlich P-S, Kroger N, Huynh A, Schafer-Eckart K, Milpied N, Lenhoff S, Ho A, Lopez JLB, Mordini N, Lioure B, Halaburda K, Olivieri A, Gedde-Dahl T, Protheroe R, Tischer J, Klammer M, Clausen J, Potter V, Ladetto M, Tilly H, Deconinck E, Brecht A, Muller LP, Heinicke T, Carrete JPT, Bazarbachi A, Remenyi P, Rubio MT, Fanin R, Perez-Simon JA, Niels M, Diez-Martin JL, Arat M, Hermine O, Socie G, Cornelissen JJ, Santarone S, Guyotat D, Bulabois CE, Bernasconi P, Johansson J-E, Vrhovac R, Greinix H, Lorenzo JLL, Apte S, Craddock C, Kobbe G, Zahrani MA, Dreger P, Lange A, Tbakhi A, Meijer E, Llamas CV, Santasusana JMR, Corradini P, Benedetti F, Rambaldi A, Gandemer V, Malfuson J-V, Kaare A, Risitano A, Petrini M, Selleri C, Wu D
Publication type: Article
Publication status: Published
Journal: Bone Marrow Transplantation
Print publication date: 01/02/2021
Online publication date: 05/09/2020
Acceptance date: 25/08/2020
ISSN (print): 0268-3369
ISSN (electronic): 1476-5365
Publisher: Springer Nature
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